Summary

Malignant lymphomas represent about 9% of cardiac neoplasms. Despite its life-threatening nature, the cardiac manifestations
are often subclinical. In about 20% of deaths from lymphoma, cardiac involvement is found only in autopsy. The authors present
the case of a 77-year-old female admitted due to intense back pain, vomiting, generalised pruritus, fatigue and weight loss.
She had a personal history of hypertension and breast cancer was noted 10 years before admission. The thoracoabdominopelvic
CT showed a mass in the left atrium with extension to the right atrium and inferior vena cava, and a paravertebral mass at
D10-D11 with invasion of the spinal canal and hepatic hilum. The transthoracic paravertebral mass biopsy was compatible with
a diffuse large B cell lymphoma. The patient developed a complete atrioventricular block, with haemodynamic instability, requiring
urgent chemoreduction of the paracardiac mass and implantation of an epicardial pacemaker.